Primary Job Functions:

Will conduct monthly billing supervision audits on all service providers providing Outpatient and/or Residential MH and ARS Services and communicate with employees

and/or the employee's clinical and/or administrative supervisor when appropriate.

Billing Audit will include reviewing notes and assessments written by the service providers confirming that note heading matches the content of the note and the service code that is being billed, Treatment plan is attached to the note and reflects what is being worked on in the session.

Perform regular audits of clinical documentation to ensure compliance with federal, state, and payer-specific regulations. Will identify documentation deficiencies and provide corrective action recommendations to provides.

Design and facilitate training programs for licensed providers and clinical staff focused on accurate clinical documentation, billing compliance, and coding best practices. Develop supportive resources such as documentation tools, templates, and tip sheets to promote consistent and compliant charting and coding.

Provide 1:1 and group education sessions, including onboarding and ongoing continuing education.

Monitor and analyze changes in regulatory requirements and coding policies and effectively collaborate and communicate relevant updates to key stakeholders.

Support the preparation and execution of internal and external audits, including the development and implementation of corrective action plan

Assist in the creation and maintenance of compliance policies and procedures related to clinical documentation and billing practices.

Courteous and respectful towards patients, visitors and co-workers

• Respects patient and providers’ privacy and confidentiality.
• Is pleasant and cooperative with others.
• Personal values don’t inhibit the ability to relate and care for others.
• Is sensitive to the provider’s needs, expectations and individual differences.

Administrative and Other Related Duties as assigned:

• Actively participates in Performance Improvement activities
• Actively participates in AH committees as requested
• Completes assigned tasks in a timely manner
• Follows AH policies and procedures
• Maintains current license and requirements for renewals (i.e. CEU’s), if applicable, and attends regular workshops and in-services

Master’s level degree or equivalent in a mental health discipline or Independent License such as an LCSW, LPCC, MSN with at least 2 years’ experience in the mental health field. Knowledge in adult and child/adolescent behavioral healthcare and intellectual disabilities outlined below, to be attained within (6) months of employment.

• Knowledge of clinical documentation requirements for inpatient, residential, and outpatient programs
• General knowledge of billing standards and practices
• Knowledge of monitoring agencies standards (JC, DMH, CMS, Medicaid, Medicare, HRSA, ABON, etc.)
• Knowledge and utilization of tools to monitor clinical compliance
• Knowledge of the organization’s policy and procedures
• Knowledge of EHR systems and documentation